Spontaneous intracranial hypotension

Czech version

Authors: A. Kopal ¹; E. Ehler ¹; M. Mrklovský ²
Authors‘ workplace: Pardubická krajská nemocnice, Pardubice Neurologická klinika Přednosta: doc. MUDr. Edvard Ehler, CSc. ¹; Multiscan, Radiologické centrum Pardubice Vedoucí: prim. MUDr. Dušan Spitzer ²
Published in: Prakt. Lék. 2010; 90(8): 486-489
Category: Case Report

Overview

Spontaneous intracranial hypotension is often the cause of a new daily persistent headache, predominantly in younger and middle-aged patients. This clinical condition is characterized by a typical triad: orthostatic headache, low spinal cerebrospinal fluid pressure and typical cranial magnetic resonance imaging findings. Headaches are accompanied by other symptoms: nausea, vomiting, photophobia, stiffness or aches in the cervical spine are commonly seen. Dizziness, diplopia and hearing disturbances are also frequent. The typical clinical picture with characteristic cranial magnetic resonance imaging and low spinal cerebrospinal fluid pressure denotes spontaneous intracranial hypotension. Treatment consists of bed rest, sufficient intake of fluids, the administration of caffeine, and corticosteroid medication. If conservative treatment is ineffective, the placement of 1 or more lumbar epidural blood patches is indicated. The authors present the case report of a 54-year-old female who had developed intracranial hypotension syndrome, with typical cranial magnetic resonance imaging, which was resolved through successful non-invasive therapy.

Key words:
spontaneous intracranial hypotension, intracranial hypotension syndrome, low spinal cerebrospinal fluid pressure.

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